Laserfiche WebLink
� ���`�'PPLICATION f0�_:,) <br /> � everett CONSTRUi TION °"�`�`" <br /> PERM T <br /> ' BUI!DING 6EPARTMENT <br /> 259-87a5 TO BE COMPLETED IN INK• PLEASE PRINT <br /> ❑ C�EMOLITION ❑COMBINATION ❑ BUILDING �(MECHANtCAL ❑ PLUMBINfi ❑SI�iN <br /> OWNER M�IL�ODPESg CITY 2iP pNONE <br /> Mo�FA�r Ge���v 113q 34'^`�,a„u.� S.ea,�4i'� i,.il}.q8122. 3z'f-3066 <br /> MCNIIECTORD[810NER M�IL�D�RE53 LITY 21P PNONE <br /> OEMFML CANTR�GTOR M�IL�OOHE55 �Itt 21P VHONE LIGEN8E• <br /> . �41�E'�11X6?AUQ sa..�-- �HOET.1C1185� <br /> M[CN�MIC�ItONTR�Gtqq M�IL�DD11E39 CIfY liP ONOHE LICFNFE• <br /> RUWINOCONTMG70(1 M�II�DDRES9 G17Y 21P PI�ONE 4CENSE� <br /> ClM!OF wORK <br /> ❑ NEW ❑ 110DITION ❑ ALTERATION ❑ REPAIR ❑ DEMOLITION ❑ WOODSTOVE/FRPL.INSERT ❑ BUILOINO RELOCAiION <br /> VqW TION OF WOOk�COSt OF MRERI�LS PLU9l�BOR1 ' <br /> I• DElCPolEWORR <br /> 1 � / 9 <br /> we oF waoua <br /> 1 HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS AR <br /> PLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL <br /> IEOILL� lCMrfqNOF►ROPE TY�6NOWNBELOWON�tt�GMFOURGOVIE51 PqOVISIONSOFLAWSANDORDINANCES60VERNIN6THISTVPE <br /> OF WORK WILL BE COMPLETED WITH NM1iETHER SPECIFIED HERE• <br /> tot_uocK—or IN OR NOT.THE GRANTI Na OF A PERMIT DOES NOT PRESUME TO <br /> � • G!VE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OK <br /> j ANY OTH ER STATE OR LOCAL LAW REQULATIN6 CONSTRUCTION <br /> I' OR THE PERFORMANCE OF CONSTRUCTION. <br /> SIONATURE OF CONTR�CTOR OR AUTHOPIZEU AOENT O�TE <br /> X 3-i3-8 <br /> � M10JEGi�D011El.7 �P �NT CITYBUSME49lICEN5EN0. <br /> ` ) 908 <br /> , <br /> I MAIM�INO MlCHANICAL <br /> i MO. TY�[OF il%NIIE FEE NO. TYPE OF EOUIPMENT FE[ <br /> WATEpCLOSET TOILE AIRCONO.UNITS-H.P.EA <br /> d1THTU8 REFRIOERATION UNITS-N.P.EA <br /> LAVATORY WA9N&181 BOILERS-H.P.E�. <br /> BNOWER OAS FIRED AC.UNITS-TONN�GE EA <br /> � KITCHEN SINK�DISP. FORCED AIR SYSTEMS-B.T.U. M EA <br /> 1 DIBNWASHER WALI HEATERS-B.i.U. M <br /> 1 UUNDRYTRAY UNITHE�TER9-B.T.U. M <br /> CLOTNES WASHER EV�PORATIVE COOLERS <br /> WATER HE�7ER CLOTHES�RVERS <br /> URIN�L VENTILATION FAN <br /> DRINKINO FOUNTAIN 'ANOE MOOD <br /> � FIOOR DMIN AIR MANDLINO UNIT- C.F.M. <br /> V�CUUM BREANERS STOVE <br /> fi00F DM�N9-PMNLEADERS METAL FIREPLACEB CHIMNEY <br /> �� SINN 9ERVICE-BAR ETC. WOODSTOVE/FIREPLACE INSERT <br /> BU!TOTAL SUBTOTAL ! <br /> �� PERMIT t PERMIT f <br /> � TOTALFEE 1 TOTALFEE • <br /> ; THIS PORTION TO BE COMPLETED BY BUILDING DEPT. PERSONNEL <br /> � FqONT9EfB�CN NEAq5E7B�CK SIDESETB�CK PUNCNECKNUMBEN VL�NCNECRfEE <br /> iEE RELEIPT NO <br /> 1 UOEiONE . IOT�REA V�C�NTSItE <br /> OYES ONO FfE6 V�lll�TION F[! <br /> � TYfEOFCONST. OCCUP�NLYGNOUP NO.OF�WELLINOUNIT9 <br /> BUIlDIN6 S <br /> BRE Oi BIDQ NO.OF SiOP1E9 M�X OLC.10�0 <br /> PLUMBING <br /> MECH�NICAL <br /> FIRE SPRINHLERS REOUIRED ❑VES ❑ NO <br /> OTHER <br /> PEN�ITY <br /> I 1PP�IGAiION�CL.BY n��N9CNEGNEOBY APPq.F00155U�NCEBY <br /> , <br /> TOTAL <br /> � 1'v� 1 <br /> .� <br />